NURS 1016 MIDTERM EXAM QUESTIONS AND ANSWERS
What are some strengths of older adults - CORRECT ANSWERS✅✅wisdom, peaceful, experienced (has
knowledge and practical life skills), and have healthier past times
Why is the proportion of population 65 or older steadily increasing? - CORRECT ANSWERS✅✅Low
fertility rates and increased life expectancy
Groups of old people - CORRECT ANSWERS✅✅young old 65-74
middle old 75-84
old old 85+
Centenarians 100+
Supercentenarian 110+
Quality of Care - CORRECT ANSWERS✅✅the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with current
professional knowledge
What are the attributes of health care quality - CORRECT ANSWERS✅✅safe, timely, effective, efficient,
equitable, patient centered.
Why is evidence important to nursing? - CORRECT ANSWERS✅✅it supports or disputes any number of
situations related to nursing practice such as approving or disputing the efficacy of a treatment, using
diagnostic tools, transmission of diseases, or any other scenario related to health care.
Canadian Gerontological Nursing Association Standards of Practice (2020) - CORRECT
ANSWERS✅✅Standard I: Relational care
Standard II: Ethical care
Standard III: Evidence informed care
Standard IV: Aesthetic/ artful care
Standard V: Safe care
Standard VI: Socio-politically engaged care
,*See page 21 of first slideshow for details on each.
Roles in Gerontological nursing are - CORRECT ANSWERS✅✅Generalist, specialist....
Implications for Gerontological Nursing and Healthy Aging - CORRECT ANSWERS✅✅-Expertise in caring
for older people can make the difference in their quality of life. This type of nursing is intellectually
challenging as you are often caring for individuals with complex needs and health care issues.
Nutrition Goals - CORRECT ANSWERS✅✅Safe, adequate nutrition for residents.
Well-being comfort and quality of life.
Respect choice and autonomy.
What are some common nutrition concerns in the elderly? - CORRECT ANSWERS✅✅As we age there is
a natural decline in:
How well nutrients are absorbed, our sense of taste, smell and vision, we have a reduced thirst
sensation, reduced saliva production which creates dry mouth and possible tooth loss, poor appetite
and malnutrition, and cognitive issues and loss of independence.
All of these things can lead to:
Weight loss and general malnutrition, dehydration, bowel problems, disease complications, dysphagia,
wounds or pressure ulcers, and vitamin and mineral deficiencies.
Philosophy of Care when feeding elderly - CORRECT ANSWERS✅✅food first, medication pass nutrition
supplementation program then additional oral supplements.
Diet Order - CORRECT ANSWERS✅✅diet orders of clients may vary and could include therapeutic diets,
texture orders, fluid orders or other comments.
Therapeutic diets in LTC - CORRECT ANSWERS✅✅Regular, diabetic, renal, renal diabetic, gluten free,
full fluids, clear fluids, NPO, tube feeding (tube feeding is not common)
,Texture order - CORRECT ANSWERS✅✅the texture order may include:
no modification, diced, minced, minced mashed, pureed.
Other comments or considerations for a diet order may include: - CORRECT ANSWERS✅✅allergies or
intolerances, no added salt, low potassium, or any food preferences.
Fluids order - CORRECT ANSWERS✅✅Fluid order may include:
No modification, nectar thick fluids, honey thick fluids.
Dysphagia - CORRECT ANSWERS✅✅chewing and swallowing problems.
possible causes may be MS, parkinsons, alzheimers, ALS, dementia, stroke, aging, or medications.
This can lead to: social isolation, withdrawal, lack of dignity, and fear of choking.
Symptoms of Dysphagia - CORRECT ANSWERS✅✅holding food in mouth aka pocketing, inability to hold
food or fluid in mouth, wet or gurgle voice, excessive chewing, coughing during or after eating or
drinking, choking incident, resident complains of swallowing difficulty. (These are symptoms of....)
Health risks of Dysphagia - CORRECT ANSWERS✅✅food and liquid entering the lung (aspiration),
pneumonia as a result of aspiration, obstruction of airway (choking), weight loss, malnutrition, reduced
quality of life. (Health risks of....)
Guidelines for eating or feeding a person with dysphagia (and feeding in general) - CORRECT
ANSWERS✅✅before meal:
make sure you are familiar with the residents feeding plan (positioning instructions, feeding aids,
feeding methods, modifications and level of supervision), make sure their mouth is clean and clear of
oral residue, excess saliva and mucous, insure the resident has their dentures, glasses or hearing aids if
needed, and wash your hands as well as the residents.
The environment should be calm and pleasant with minimal distractions, and turn the tv down as you
can have a pleasant conversation. Avoid talking over the resident to carry on conversation with staff.
For positioning make sure they are seated upright as close to 90 degrees as possible head positioned
straight or slightly forward with a pillow to support neck and shoulders and always be alert.
, Check the tray for diet order, feed with food coming from below level of residents mouth, place food on
side of mouth that is stronger for the resident. Make sure you have time to feed and do not rush.
Residents may tire easily provide rest.
Maintain postive attitude toward the meal regardless of your preference of the food and texture. Feed
slowly with only 1/2- 1 tsp at a time and allow time to chew and swallow. Maintain a moist mouth
during feeding by giving fluids in between food, and ensure mouth is clear before giving more food or
liquid. DO NOT rinse food down with liquid as this increases the risk of aspiration. It may be beneficial to
alternate between solids and fluids.
Some residents may need encouragement to close lips around spoon or cup.
If resident is holding food in mouth stimulate swallowing. We do this by presenting an empty spoon as if
giving more food, touching empty spoon to residents bottom lip, gently touching outside of his or her
cheek and/or providing verbal encouragement to swallow.
IF resident coughs or chokes during feeding DO NOT o
Why do we have texture modified diets? - CORRECT ANSWERS✅✅to maintain or achieve normal food
intake while reducing the risk of aspiration and choking in individuals with dysphagia. Our goal is to
provide the safest food consistency to maintain the best nutrition and pleasurable eating experience
with the least modification. REMEMBER not everyone falls into a diet texture category perfectly.
Texture Modification: Diced - CORRECT ANSWERS✅✅1.0 cm max.
Must be easy to pickup with fingers or utensils, foods that are usually picked up do not need to be cut
up like sandwiches.
(not for dysphagia)
We use this diet for mechanical problems with cutting food such as stroke or perceived independence.
Texture Modification: Minced - CORRECT ANSWERS✅✅0.5 cm max
meats and mixed dishes are moist and minced.
meat requires minimal chewing
We use this with problems chewing and or swallowing, or if the pt tires easily or has oral dental issues.
Texture Modification: Minced/Mashed - CORRECT ANSWERS✅✅0.5 cm max
meat is minced, vegetables are mashed, soups and desserts are blended and food is moist to facilitate
swallowing.
What are some strengths of older adults - CORRECT ANSWERS✅✅wisdom, peaceful, experienced (has
knowledge and practical life skills), and have healthier past times
Why is the proportion of population 65 or older steadily increasing? - CORRECT ANSWERS✅✅Low
fertility rates and increased life expectancy
Groups of old people - CORRECT ANSWERS✅✅young old 65-74
middle old 75-84
old old 85+
Centenarians 100+
Supercentenarian 110+
Quality of Care - CORRECT ANSWERS✅✅the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with current
professional knowledge
What are the attributes of health care quality - CORRECT ANSWERS✅✅safe, timely, effective, efficient,
equitable, patient centered.
Why is evidence important to nursing? - CORRECT ANSWERS✅✅it supports or disputes any number of
situations related to nursing practice such as approving or disputing the efficacy of a treatment, using
diagnostic tools, transmission of diseases, or any other scenario related to health care.
Canadian Gerontological Nursing Association Standards of Practice (2020) - CORRECT
ANSWERS✅✅Standard I: Relational care
Standard II: Ethical care
Standard III: Evidence informed care
Standard IV: Aesthetic/ artful care
Standard V: Safe care
Standard VI: Socio-politically engaged care
,*See page 21 of first slideshow for details on each.
Roles in Gerontological nursing are - CORRECT ANSWERS✅✅Generalist, specialist....
Implications for Gerontological Nursing and Healthy Aging - CORRECT ANSWERS✅✅-Expertise in caring
for older people can make the difference in their quality of life. This type of nursing is intellectually
challenging as you are often caring for individuals with complex needs and health care issues.
Nutrition Goals - CORRECT ANSWERS✅✅Safe, adequate nutrition for residents.
Well-being comfort and quality of life.
Respect choice and autonomy.
What are some common nutrition concerns in the elderly? - CORRECT ANSWERS✅✅As we age there is
a natural decline in:
How well nutrients are absorbed, our sense of taste, smell and vision, we have a reduced thirst
sensation, reduced saliva production which creates dry mouth and possible tooth loss, poor appetite
and malnutrition, and cognitive issues and loss of independence.
All of these things can lead to:
Weight loss and general malnutrition, dehydration, bowel problems, disease complications, dysphagia,
wounds or pressure ulcers, and vitamin and mineral deficiencies.
Philosophy of Care when feeding elderly - CORRECT ANSWERS✅✅food first, medication pass nutrition
supplementation program then additional oral supplements.
Diet Order - CORRECT ANSWERS✅✅diet orders of clients may vary and could include therapeutic diets,
texture orders, fluid orders or other comments.
Therapeutic diets in LTC - CORRECT ANSWERS✅✅Regular, diabetic, renal, renal diabetic, gluten free,
full fluids, clear fluids, NPO, tube feeding (tube feeding is not common)
,Texture order - CORRECT ANSWERS✅✅the texture order may include:
no modification, diced, minced, minced mashed, pureed.
Other comments or considerations for a diet order may include: - CORRECT ANSWERS✅✅allergies or
intolerances, no added salt, low potassium, or any food preferences.
Fluids order - CORRECT ANSWERS✅✅Fluid order may include:
No modification, nectar thick fluids, honey thick fluids.
Dysphagia - CORRECT ANSWERS✅✅chewing and swallowing problems.
possible causes may be MS, parkinsons, alzheimers, ALS, dementia, stroke, aging, or medications.
This can lead to: social isolation, withdrawal, lack of dignity, and fear of choking.
Symptoms of Dysphagia - CORRECT ANSWERS✅✅holding food in mouth aka pocketing, inability to hold
food or fluid in mouth, wet or gurgle voice, excessive chewing, coughing during or after eating or
drinking, choking incident, resident complains of swallowing difficulty. (These are symptoms of....)
Health risks of Dysphagia - CORRECT ANSWERS✅✅food and liquid entering the lung (aspiration),
pneumonia as a result of aspiration, obstruction of airway (choking), weight loss, malnutrition, reduced
quality of life. (Health risks of....)
Guidelines for eating or feeding a person with dysphagia (and feeding in general) - CORRECT
ANSWERS✅✅before meal:
make sure you are familiar with the residents feeding plan (positioning instructions, feeding aids,
feeding methods, modifications and level of supervision), make sure their mouth is clean and clear of
oral residue, excess saliva and mucous, insure the resident has their dentures, glasses or hearing aids if
needed, and wash your hands as well as the residents.
The environment should be calm and pleasant with minimal distractions, and turn the tv down as you
can have a pleasant conversation. Avoid talking over the resident to carry on conversation with staff.
For positioning make sure they are seated upright as close to 90 degrees as possible head positioned
straight or slightly forward with a pillow to support neck and shoulders and always be alert.
, Check the tray for diet order, feed with food coming from below level of residents mouth, place food on
side of mouth that is stronger for the resident. Make sure you have time to feed and do not rush.
Residents may tire easily provide rest.
Maintain postive attitude toward the meal regardless of your preference of the food and texture. Feed
slowly with only 1/2- 1 tsp at a time and allow time to chew and swallow. Maintain a moist mouth
during feeding by giving fluids in between food, and ensure mouth is clear before giving more food or
liquid. DO NOT rinse food down with liquid as this increases the risk of aspiration. It may be beneficial to
alternate between solids and fluids.
Some residents may need encouragement to close lips around spoon or cup.
If resident is holding food in mouth stimulate swallowing. We do this by presenting an empty spoon as if
giving more food, touching empty spoon to residents bottom lip, gently touching outside of his or her
cheek and/or providing verbal encouragement to swallow.
IF resident coughs or chokes during feeding DO NOT o
Why do we have texture modified diets? - CORRECT ANSWERS✅✅to maintain or achieve normal food
intake while reducing the risk of aspiration and choking in individuals with dysphagia. Our goal is to
provide the safest food consistency to maintain the best nutrition and pleasurable eating experience
with the least modification. REMEMBER not everyone falls into a diet texture category perfectly.
Texture Modification: Diced - CORRECT ANSWERS✅✅1.0 cm max.
Must be easy to pickup with fingers or utensils, foods that are usually picked up do not need to be cut
up like sandwiches.
(not for dysphagia)
We use this diet for mechanical problems with cutting food such as stroke or perceived independence.
Texture Modification: Minced - CORRECT ANSWERS✅✅0.5 cm max
meats and mixed dishes are moist and minced.
meat requires minimal chewing
We use this with problems chewing and or swallowing, or if the pt tires easily or has oral dental issues.
Texture Modification: Minced/Mashed - CORRECT ANSWERS✅✅0.5 cm max
meat is minced, vegetables are mashed, soups and desserts are blended and food is moist to facilitate
swallowing.
